The Role of Adjunctive Rodogyl Therapy in the Treatment of Advanced Periodontal Disease

Le résumé fourni par la source

Several studies have indicated that the combination of metronidazole and spiramycin is synergistic against anaerobic bacteria and may be effective against oral infections. The present study sought to determine the efficacy and safety of a commercial preparation of these two antibiotics (Rodogyl) when used adjunctively in the treatment of advanced periodontal disease. In a double‐blind parallel randomized trial, 56 patients (mean age = 44 years) with advanced periodontitis (50 of whom completed the study) were assigned to either the Rodogyl or placebo group. Both groups were thoroughly scaled and root planed for approximately 6 hours, with one group receiving Rodogyl for 2 weeks and the other a placebo. No other therapy was received during the study period. Two sites in each patient with probing depths of at least 7 mm were selected for study. Plaque level (PlI), gingival inflammation (GI), probing depth (PD), and attachment level (AL) were measured at baseline, 14 days, 1 month, and then at monthly intervals up to 6 months. Subgingival bacteria were monitored with dark‐field microscopy. The development of resistant bacteria, as well as side effects to the medications, was also monitored. The Rodogyl group exhibited a greater gain in AL (0.67 mm) from the 2‐month interval until the end of the study. Although this difference was statistically significant ( P < 0.05), it was not necessarily of biologic significance. There was a significantly greater decline in the proportion of spirochetes in the Rodogyl group at the 14‐day interval, and this difference remained significant ( P < 0.05) at all study intervals. No difference in the proportion of motile organisms was observed. At the 6‐month interval, there were no significant differences in resistant bacteria. Diarrhea was recorded in 8% of the subjects in the Rodogyl Group. The adjunctive use of Rodogyl in the therapy of advanced periodontitis resulted in a significant increase in attachment level as well as a significant decrease in the proportion of spirochetes, and both of these changes were sustained until the end of the study.

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